Hypertension:Pazopanib,VEGF受体抑制剂,治疗肾细胞癌患者时诱导高血压发生发展的潜在机制。

2018-01-10 MedSci MedSci原创

靶向VEGF(血管内皮生长因子)的药物通常与高血压的快速发展相关,但其机制尚未完全了解。VEGF表达于肾上皮细胞,可刺激产生NO。在肾髓质,通过局部L-NAME或破坏内皮素-1抑制NO的形成,可导致高血压。研究人员推测VEGF受体抑制剂疗法是通过减少肾髓质NO和内皮素-1的形成,导致高血压的发生。研究人员进行一单中心前瞻性观察性实验上述推论进行验证,招募了27位采用受体酪氨酸激酶抑制剂pazopa

靶向VEGF(血管内皮生长因子)的药物通常与高血压的快速发展相关,但其机制尚未完全了解。VEGF表达于肾上皮细胞,可刺激产生NO。在肾髓质,通过局部L-NAME或破坏内皮素-1抑制NO的形成,可导致高血压。研究人员推测VEGF受体抑制剂疗法是通过减少肾髓质NO和内皮素-1的形成,导致高血压的发生。

研究人员进行一单中心前瞻性观察性实验上述推论进行验证,招募了27位采用受体酪氨酸激酶抑制剂pazopanib治疗的转移性肾细胞癌患者。监测患者血压,并于治疗前、治疗4周和8周时分别采集患者的血浆和尿液。

治疗4周后,患者的收缩压和舒张压均升高,心率显着下降;尿蛋白/肌酐比值明显增加,而肾小球滤过率未发生改变。尿硝酸盐/硝酸盐(NOx)和cGMP/肌酐显着降低,而尿内皮素-1/肌酐比值和FENa+则没有变化。血浆中NOx、cGMP和脑钠肽显着降低,而内皮素-1则明显增加。白细胞计数明显减少,但CRP(C反应蛋白)未变。

总而言之,晚期肾细胞癌患者采取pazopanib治疗与其发生高血压、蛋白尿、骨髓抑制和血浆/尿NO合成代谢减少均相关。

原始出处:

Anne Robdrup Tinning, et al.Pazopanib-Induced Hypertension in Patients With Renal Cell Carcinoma Is Associated With Low Urine Excretion of NO Metabolites.Hypertension. January 8, 2018. https://doi.org/10.1161/HYPERTENSIONAHA.117.10225

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objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzR8ylhYfiaoAUx2BsaYHVia1IKhG3Cg8CT84rBrn6iaVRkyAibJxBcLEXabOQ5p19vWgDe34ib5ErxNgx/0, createdBy=8a701629084, createdName=jihuaijun1112, createdTime=Fri Jan 19 00:09:01 CST 2018, time=2018-01-19, status=1, ipAttribution=)]
    2018-03-28 feather89
  5. 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objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzR8ylhYfiaoAUx2BsaYHVia1IKhG3Cg8CT84rBrn6iaVRkyAibJxBcLEXabOQ5p19vWgDe34ib5ErxNgx/0, createdBy=8a701629084, createdName=jihuaijun1112, createdTime=Fri Jan 19 00:09:01 CST 2018, time=2018-01-19, status=1, ipAttribution=)]
    2018-03-29 小贝熊

    学习学习学习

    0

  6. 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objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzR8ylhYfiaoAUx2BsaYHVia1IKhG3Cg8CT84rBrn6iaVRkyAibJxBcLEXabOQ5p19vWgDe34ib5ErxNgx/0, createdBy=8a701629084, createdName=jihuaijun1112, createdTime=Fri Jan 19 00:09:01 CST 2018, time=2018-01-19, status=1, ipAttribution=)]
    2018-03-29 小贝熊

    学习学习

    0

  7. 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    2018-03-28 小贝熊

    学习学习学习

    0

  8. 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  9. 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  10. 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    2018-01-19 jihuaijun1112

    学习学习学习

    0

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慢性肾脏病(CKD)患儿血压控制不良被认为是CKD进展的主要原因,同时会增加心血管疾病的风险。近期,有推荐更好的控制血压(BP)的方法。本文主要目的是对比CKiD研究(儿童慢性肾脏病)中的受试者在两个时间段血压控制情况。对两个时间段(2005年1月1日-2008年7月1日[1期,345人]和2010年7月1日-2013年12月31日[2期,506人])的851位受试者的抽检BP和24小时动态BP数

Hypertension:脉搏波速度可预测青年血压的进展和高血压的发生!

这些结果表明,PWV可预测血压的进展,为年轻的成年人高血压的风险预测提供一个有价值的工具。

Lancet:中国成年人高血压患病、知晓、治疗和控制形势严峻!

2017年12月,发表在《Lancet》的一项由中国和美国科学家进行的研究,考察了在35~75岁的中国成年人中,高血压的患病率、知晓率、治疗率和控制率。